Instrument with independent pliers

Surgery – Instruments – Forceps

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A61B 1700

Patent

active

061622397

DESCRIPTION:

BRIEF SUMMARY
DESCRIPTION

1. Field of the Invention
The invention relates to an instrument for application in endoscopic surgical operations.
2. Prior art
An instrument having a shaft which receives two forceps, extending beyond a distal end of the shaft and pivotal toward and away from one another about an axis extending orthogonally to a longitudinal axis of the shaft is known from the German Patent DE 43 24 254 C1.
In quite a number of cases in endoscopic surgery it is now necessary to "contract" two tissue fragments which are separated from each other, to maintain them in this contracted state, and to unite them then, e.g. by a suturing or by an adhesive operation.
Examples of such operations may be found in surgical operations of torn ligaments in a joint such as the knee joint, or the in-vitro fertilisation of the fallopian tubes. Another example is described in the article by D. J. TIBBS et al. "Arterial Replacement with Minimal Interruption of Blood Flow", published in The Lancet, 1958, pp. 292 to 294".
The performance of these operations with conventional instruments requires not only comparatively long time but also a great manual skill of the physician performing the operation because the surgeon must handle several instruments introduced into the human body and co-ordinate their movements.
The instrument known from the German Patent DE 43 24 254 C1, too, is only conditionally suitable for the performance of such operations because the two bendable forceps, which are introduced separately of each other into a shaft including several ducts, do not allow for a coordinated movement in the sense of a selective approach of the two forceps to each other. Moreover, the individual ducts are disposed on the apeces of an equilateral triangle so that the manipulation of the contracted tissue fragment is rendered more complicated by an instrument introduced through the third duct. Moreover, the jaw elements present an inexpedient orientation relative to the pivoting axis so that a "contraction" of sensitive tissue fragments is not possible.


BRIEF DESCRIPTION OF THE INVENTION

The present invention is based on the problem of providing an instrument for application in endoscopic surgery, which will facilitate the "contraction" of two tissue fragments which are separate from each other, the holding of the tissue fragments in the contracted state and the subsequent manipulation, e.g. the connection by a suturing or adhesive process.
In accordance with the invention both forceps elements are each pivotable as a unit about parallel pivoting axes such that their mutual spacing in the direction of the transverse axis of the instrument may be varied. With these pivoting axes being at least approximately orthogonal on the longitudinal axis of the instrument the adjusting range for the spacing between the forceps elements is substantially greater than the diameter of the instrument which is restricted by the maximum "opening in the body" available.
Each of the forceps elements has a pair of jaws spaced from one another and extending from elements the distal discharge opening of a continuous duct so that (inter alia) a surgical instrument may be introduced in the duct for co-operation with the jaws of the two forceps elements.
With this inventive configuration the following method can be performed for connecting tissue fragments separated from each other:
The inventive instrument is introduced into the cavity where the tissue fragments to be united are located. The free ends of the tissue fragments, e.g. the fallopian tubes, are seized with the jaw of one respective forceps element of the instrument. Then the forceps jaws of the forceps elements are "approached to each other" in a direction orthogonal on the longitudinal axis of the instrument. With the two forceps elements of the instrument holding the tissue fragments, the free ends of the tissue fragments to be united are moved towards each other, too. As soon as the free ends have reached a position in which the bonding operation can be performed the operating physician perfo

REFERENCES:
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patent: 5100421 (1992-03-01), Christoudias
patent: 5236437 (1993-08-01), Wilk et al.
patent: 5275609 (1994-01-01), Pingleton et al.
patent: 5318013 (1994-06-01), Wilk
patent: 5330502 (1994-07-01), Hassire et al.
patent: 5423813 (1995-06-01), Kaiser et al.
patent: 5423830 (1995-06-01), Schnerbaum et al.
patent: 5527332 (1996-06-01), Clement
patent: 6017358 (2000-01-01), Yoon et al.
J. J. Tibes and W. G. Leslie, "Arterial Replacement with Minimal Interruption of Blood Flow", The Lancet, Feb. 8, 1958, pp. 292-294.
Elsbeth Heinzelmann, "Intelligence Winzlinge fur Die Chirurgie", Tranfyer Nr. 24, Jun. 20, 1994, pp. 48-52.

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